The RCGP Primary Care Development Team assisted a practice in developing a new leadership structure and rectify a number of issues in preparation for a CQC re-inspection.
The issue
A practice was rated as ‘Inadequate’ by the CQC, specifically in the areas of Safety and being Well-Led. The practice was placed into Special Measures. The inspection advised the practice was struggling with leadership issues:
- The vision for the practice was not being communicated to staff and what their responsibilities were.
- Policies and procedures required review.
- There were no regular performance reviews.
- Staff were not aware of how the practice was performing.
- Proper documentation was not in place regarding internal investigations.
- Training was required around chaperoning and other safety issues.
- The practice did not meet cleanliness standards.
How we helped
Our Primary Care Development Team helped prepare the practice for their CQC reinspection. Our team consisted of three advisors: a GP, Practice Manager and Practice Nurse. Each worked with their relevant area of the practice to bring them back on track.
They found that the practice had recently undertaken a merger which had not gone well, and at the same time had changed their computer system. As a result, the practice’s leadership had neglected to notice issues that had arisen regarding support for their nursing staff. Their practice manager was overwhelmed and not coping well.
A detailed action plan was produced for the practice and advisors to have a common document to work with and measure progress.
The action plan included:
- implementing a staff appraisal process
- reviewing their processes and risk assessment procedures
- putting infection control and cleanliness processes in place
- improving communication with staff through updated policies
- ensuring minutes from regular staff meetings were available to all staff.
Most importantly, our team provided personal, peer-to-peer support to encourage and guide the individuals of the practice through the challenges they were facing and reinstate a high performing team.
Outcomes / impact
As a result of this work, the CQC re-inspection rated the overall practice as ‘Good’ and ‘Good’ in four out of five areas.